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General NPI Number Information
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NPI Number | 1992797476
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Entity Type | Individual
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Provider Name | STEPHANIE BALDWIN HERNDON A.C.N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 7611 FOREST AVE SUITE 410
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City | RICHMOND
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State | VA
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Zip | 23229-4946
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Country | US
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Telephone | 804-285-2965
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Fax | 804-288-6602
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Provider Business Mailing Address
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Address Line | 2369 STAPLES MILL RD SUITE 200
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City | RICHMOND
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State | VA
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Zip | 23230-2909
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Country | US
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Telephone | 804-285-8206
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Fax | 804-497-5469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024166223
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License Number State | VA
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